Healthcare Provider Details

I. General information

NPI: 1699972828
Provider Name (Legal Business Name): PAMELA A BECKER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 03/02/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 NW KINGS BLVD
CORVALLIS OR
97330-2505
US

IV. Provider business mailing address

3510 NW GLEN RIDGE DR
CORVALLIS OR
97330-3212
US

V. Phone/Fax

Practice location:
  • Phone: 541-752-7779
  • Fax: 541-752-8659
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0007785
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36531
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202006071
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0007785
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: